Plate Removal Surgery for Distal Humerus Fractures

Surgical removal of a plate for a distal humeral fracture?

Hello, my husband (31 years old) suffered a comminuted fracture of the left humerus in a car accident at the end of July last year.
After evaluation, he opted for self-funded plate fixation, but his recovery has been slow, and he experiences pain or a catching sensation in his wrist at certain angles.
During a follow-up visit in December, the doctor suggested that since he is still young, the plate could be removed to allow the bone to heal on its own, which may alleviate or eliminate the pain and catching sensation.
The surgery is scheduled for March.
I would like to ask if this is considered a minor surgery? Will he need someone to accompany him? What post-operative care should we be aware of? Thank you for your response!

reiny, 30~39 year old female. Ask Date: 2016/02/05

Dr. Shi Guozheng reply Orthopedics

Although the surgery is minor, it is still a type of surgery.
The radial nerve runs near the distal humerus, so the procedure must be performed with caution.
It is advisable to have someone accompany you, and you should avoid strenuous activities for three months post-surgery.

Reply Date: 2016/02/05

More Info

The decision to remove a plate after a distal humerus fracture is a significant one, and it’s understandable that you have questions regarding the procedure, recovery, and post-operative care.
First, let's address whether this surgery is considered a "minor" procedure. While plate removal is generally less invasive than the initial surgery to fix the fracture, it is still a surgical procedure that carries risks, such as infection, bleeding, and nerve or tendon damage. The complexity of the surgery can vary based on the specific circumstances of the fracture and the placement of the plate. In your husband's case, since he has experienced persistent pain and discomfort, the removal of the plate may indeed help alleviate these symptoms.
Regarding whether someone should accompany him to the surgery, it is highly advisable. Post-operative care is crucial, and having someone to assist him can make a significant difference, especially in the immediate recovery period. He may experience grogginess from anesthesia and will likely need help with transportation home and assistance with daily activities during the initial recovery phase.

As for post-operative care, here are several important considerations:
1. Pain Management: After the surgery, it’s common to experience pain at the surgical site. The doctor will likely prescribe pain medication, and it’s important to follow the prescribed regimen to manage discomfort effectively.

2. Wound Care: Keeping the surgical site clean and dry is essential to prevent infection. Follow the surgeon's instructions regarding when and how to change dressings.

3. Activity Restrictions: Initially, he may need to limit the use of his arm to allow for proper healing. The surgeon will provide guidelines on when he can gradually return to normal activities, including physical therapy.

4. Physical Therapy: Once cleared by the surgeon, physical therapy may be recommended to regain strength and mobility in the wrist. This is crucial for restoring function and alleviating any lingering discomfort.

5. Signs of Complications: Be vigilant for any signs of complications, such as increased swelling, redness, warmth around the incision, or fever. If any of these occur, it’s important to contact the healthcare provider immediately.

6. Follow-Up Appointments: Regular follow-up visits with the orthopedic surgeon are necessary to monitor the healing process and address any concerns that may arise.

In conclusion, while the removal of the plate can be a relatively straightforward procedure, it is still important to approach it with care and attention to post-operative recovery. By preparing adequately and following medical advice, your husband can optimize his recovery and hopefully experience relief from the pain and discomfort he has been experiencing. Always feel free to reach out to the healthcare provider with any questions or concerns before and after the surgery.

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